How can value demonstration play an important role in pharma market access
In March of 2018, D2 was commissioned to provide Trade, Distribution, and Market Access support for an international companies’ first branded product launch in the United States. D2 was to provide guidance in gaining market access and commercialization to this newly acquired HMG-CoA reductase inhibitor for patients with primary hyperlipidemia. The product was being launched into a highly generic dominated market with a bioequivalent competitor which was launched earlier.
D2 used a project management approach to help brand managers achieve the greatest pharma market access. D2 helped the brand managers understand the market access landscape by preparing a plan that outlined the target therapeutic class.
We were able to get the new-to-market policies for every payor and PBM so that until P&T determinations are made – patient, HCP, and field teams understood what happened on day 1 of launch.
D2 helped to determine the opportunities and challenges of rebating vs patient assistance programs. A value proposition was prepared with coverage and reporting for the top 50 accounts with commercial, Medicare, Medicaid, and VA status.
Through collaboration with our customer D2 was able to utilize clinical attributes that could be strategically used to open formulary opportunities in hard to reach ADAP government programs. About 240 thousand lives through ADAP network pharmacies across the United States gained greater access to this lipidemic drug.
D2 was also able to gain access to 28 million lives by creating a strategy that removed the lipidemic drug from a PBM Exclusion list. The PBM has followed an aggressive formulary exclusion approach since 2014. These exclusions historically drive competition between brands to allow generics to gain preferable status. This PBM was one of the trendsetters in using formulary exclusions and still uses drug exclusions as one of the major approaches to attain lowest net cost.
D2 was able help update and broker the presentation of a strong clinical story for this lipidemic drug. We were able to put together a strong financial “win/win” story that moved our client from being excluded in a competitive generic market to open access. By applying our relationships and experience to this initiative we were able to move from the list within 6 months. Once a product goes onto the Exclusion List it is extremely difficult to come off.